I am 49 and have not had a period since last April. I am on HRT (e gel, progesterone tablet) since then for extreme fatigue and night sweats . Have been doing well until about 6 weeks ago, regular doctor noticed my thyroid went lower and increased my synthroid from 88 to 100 mcg. Just tested last week that thyroid is now normal level but I am having severe fatigue again. I have the insomnia too, so I am on the zoloft/trazadone combo at night. Without the night meds, I am unable to fall asleep. What is causing the severe fatigue again? Estrogen dropping again? I feel terrible - shaky, weak, pale, exhausted. Feels like flu fatigue or dehydration fatigue but is not either of those. Contacted my GYN for blood test. Suggestions?